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General NPI Number Information
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NPI Number | 1003841958
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Entity Type | Individual
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Provider Name | RICHARD SCOTT ELLOWAY MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 209 LILLY RD NE STE B
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City | OLYMPIA
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State | WA
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Zip | 98506-5030
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Country | US
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Telephone | 360-413-8250
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Fax | 360-413-8830
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Provider Business Mailing Address
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Address Line | 1657 VIEW POINT CT SW
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City | TUMWATER
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State | WA
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Zip | 98512-6357
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD00029202
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License Number State | WA
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